Purpose: This study evaluated the effectiveness of bipolar hemiarthroplasty with a cementless femoral stem for hip fractures in patients older than 70 years with osteoporosis. Materials and Methods: This study examined 84 hips with osteoporosis that are available to follow up of more than 2 years, between July 1997 and May 2006. The clinical evaluation was carried out using the Koval classification before the fracture and at the last follow-up, and the Harris hip score at the last follow up. The radiological evaluation was carried out using the plain radiographs. Results: The average follow up period was 31.4 months. The Koval classification was as follows: recovery to the condition before the fracture in 25 cases (30.1%), degradation by 1 class in 56 cases (67.5%) and degradation by 2 classes in 2 cases (2.4%). The Harris hip score was 82.7 points at the last follow-up. One case (1.2%) showed cortical hypertrophy and all cases showed stable insertion of the femoral stem. Conclusion: Bipolar hemiarthroplasty with a cementless femoral stem is effective and satisfactory, both clinically and radiologically, for the treatment of elderly patients with fractures around the hip.
Aged ; Femur ; Follow-Up Studies ; Hemiarthroplasty ; Hip ; Hip Fractures ; Humans ; Hypertrophy ; Neck ; Osteoporosis

BACKGROUND AND OBJECTIVES: From a clinical standpoint, coronary artery disease in blood vessels measuring 2.5 mm to 2.75 mm, as accessed by quantitative coronary angiography (QCA), has been classified as a small vessel disease, and it is treated with percutaneous coronary intervention (PCI). The aim of this study was to evaluate the discrepancy of vessel size between intravascular ultrasound (IVUS) and QCA, and its late outcome before and after stent implantation in patients with small coronary artery disease (2.5-2.75 mm). SUBJECTS AND METHODS: We enrolled 135 patients having 143 lesions who underwent IVUS-guided PCI. Twenty-three patients (26 lesions) were in the small vessel (SV, < or =2.75 mm) group and 112 patients (128 lesions) were in the large vessel (LV, >2.75 mm) group. We evaluated the IVUS and QCA parameters' association with mortality, acute myocardial infarction (AMI) and target vessel revascularization (TVR) at the 1 year follow-up. RESULTS: On QCA, the pre-interventional reference vessel diameters and post-stent minimal lumen diameters in the SV group were smaller than those in the LV group. The discrepancy of vessel size between IVUS and QCA at the reference site was larger in the SV group than that in the LV group (1.44 mm vs. 0.92 mm, respectively p<0.05). This discrepancy was significantly associated with the plaque area in both groups (p<0.001). Despite of having larger stents implanted in the SV group than the LV group, there was no difference in mortality, AMI and TVR after 1 year between the 2 groups. CONCLUSION: A coronary artery disease measuring 2.5 mm to 2.75 mm by QCA revealed large vessels with a high percentage of plaque. The bigger stent implantation using IVUS did not show more complications after PCI and there were favorable clinical outcomes at 1 year for patients with this condition.
Angioplasty ; Blood Vessels ; Coronary Angiography* ; Coronary Artery Disease ; Coronary Vessels ; Follow-Up Studies ; Humans ; Mortality ; Myocardial Infarction ; Percutaneous Coronary Intervention ; Stents* ; Ultrasonography*

Malignant hyperthermia is a potentially fatal hypermetabolic syndrome characterised by hyperpyrexia and skeletal muscle rigidity. It can be induced by all of the currently used inhalation anesthetics or by injection of succinylcholine. A case of malignant hyperthermia was experienced which developed 80 minute after induction of general anesthesia with thiopental sodium, suecinylcholine, halothane, N2O and O2. One and half hours after induction, arrhythmia developed and was followed by unstable blood pressure, hyperpyrexia and muscle rigidity. Anesthesia was terminated and vigorous emergency treatment and dantrolene were administered. The patient recovered normal body temperature and consciousness, but expired about 4 days after induction because of late complication including disseminated intravascular coaggulation. The etiologic factor, clinieal feature, treatment and prevention of Malignant hyperthermia are discussed.
Anesthesia* ; Anesthesia, General ; Anesthetics, Inhalation ; Arrhythmias, Cardiac ; Blood Pressure ; Body Temperature ; Consciousness ; Dantrolene ; Emergency Treatment ; Halothane ; Humans ; Malignant Hyperthermia* ; Muscle Rigidity ; Muscle, Skeletal ; Succinylcholine ; Thiopental